Kidney Infection with permanent damage

My 7-month old puppy was just diagnosed with pyelonephritis. She was given four intensive mitaban dips for mites previously by a vet that was "let go" suddenly. The kidney disease was found during routine blood work before she was fixed about two weeks ago, the vet said the disease was so bad if we had not brought her in she would have been dead in two months. Would the dips have made that problem worse? I am not sure I feel confident with our vet now and want to make sure his treatment is what you would do. She is on a special diet and taking one 136 mg pill of Baytril a day for three - four months. However, I read this can damage joints of growing dogs. The vet is charging us $125 for 20 pills. Thank you so much for your help, I dont know who else to turn to. Sincerely, Sue

Did you post this to Dr. Cheng on the Ask a Vet Forum? I don't know if the mitaban could be the culprit or not. As for kidney disease, and dealing with it, have a look at a couple questions I posted to Dr. Cheng on that subject. Lots and lots of info and suggestions. There really isn't much you can do for it other than treat the symptoms as best you can.

From what I've learned, the most important thing is to control the nausea and get the dog to eat, even if it's food that isn't the best for kidney disease. If your vet prescribed reglan (metoclopromadine) for nausea, watch out for any side effects like shaking, whining and crying, and general restlessness. Reglan is processed in the kidneys, and if the kidneys aren't working, a toxic dose can build up in the blood. I've discovered that half the prescribed dose seems to be doing fairly well, but as the damage gets worse, we'll have to find something else.

Regarding diet - the objective is not so much lower protein (protein gets processed in the kidneys) but to feed a more digestible, easily broken down protein. Phosphorous is your Public Enemy No.1 for damaged kidneys, so you'll need to learn what foods are low in phosphorous. Most homemade diet recipes will be high on fatty meats (fat contains less phosphorous than lean meat), and carbohydrates like rice. Egg whites, boiled dark chicken meat with the skin, fatty ground beef, pork and lamb will work too. When cooking the ground meats, don't overcook as that makes more phosphorous available.

Next, you'll need to add calcium (Tums) and/ or aluminum hydroxide (antacid) to the diet. Get ready to practice your doggy pilling techniques, because you're looking at poking a whole lot of pills into the dog. The calcium and aluminum bind to phosphorus in the body and help flush it out. Of course, such a young puppy needs a certain amount of phosphorus for healthy bones, but the kidney disease is life threatening, and soft bones aren't. If your pup's calcium levels are high, look around for the aluminum hydroxide antacids. I could only find it locally in liquid form, and turned to the internet to find pills. It's a product called Alu-tab.

We also spent a ton of money on a couple of supplements from the vet: Azodyl capsules and Epakitin powder. In reading the labels, they mostly rely on calcium and contain a few other trace minerals. Frankly, I think I can achieve the same effect (if not better) by judiciously watching diet, adding Tums or Alu Tab, and a vitamin. I found ONE vitamin that didn't contain phosphorus: Nutri-Vet Senior Vitality. Ask your vet if that would be appropriate for your puppy. Pepcid or Zantac can help with nausea and the high acid levels of kidney patients, but might cause appetite issues. You'll just have to keep an eye out, and if the pup won't eat, lay off the pepcid for a couple days and see if it doesn't improve.

Once damage has been done to the kidneys, it can't be reversed. Your objective is to protect what good kidney tissue your dog has left for as long as possible. Urine accidents are also common with kidney disease, so take her outside as often as possible, or set up an inside station with training pads. Put the pads under her bedding as well and get ready to do some last minute laundry sometimes. We've had no further accidents after making sure our dog is on empty tanks before she goes to bed. We relied on a doggy door for too long, and she just can't feel it when she needs to go until it's too late.

Sorry I wrote you a book! Looks like we're in the same boat, so post back and let us all know how it goes. :-)

Get ready for a roller coast ride with kidney disease. Some days are going to be fairly bad with the dog vomiting and not wanting to anything. Some days she'll be close to normal, or simply normal.

Wow, I appreciate all of your advice more than you know. I will read and re-read your suggestions on diet and vitamins. The weird thing is she is not showing any symptoms of this disease. She has always been a mellow pup - but no vomiting, huge appetite, always running and playing with the other dogs and no real signs of pain. I will check with the doctor on the dips. Do you give your dog rawhide chew toys? She is teething and needs something to keep her away from shoes and plants! I give them to her twice a day. Do you think this is OK with her kidney problems? If not, can you suggest a "treat" that is compatible with the disease? I am so happy and relieved to hear all of your suggestions from personal experience. I love her to death and want her to be happy and comfortable. Thanks again. Jennifer

Here is a link to an extremely informative site about dogs with kidney disease. I suggest you print out the article (easly 40 pages) and take your time leafing through it. This woman really does a great job of explaining kidney disease, diet and supplements, and what foods contain phosphorus, etc. It has been invaluable in my education about renal failure. I agree with the author that the first item of importance is getting the dog to eat, even if it isn't the best food for the kidneys. My normally 60+ pound dog lost 15 pounds in 3 weeks before we got it diagnosed. I'm also pleased to report that the past few days she has really perked up. She doesn't eat much at one time, but gets plenty of food in small amounts throughout the day, and has now gained a good 5 pounds back. I know she'll never be her old Type-A self again, but she has short bursts of energy now - enough for a few rounds of All-Star Dog Wrestling with our other dog. LOL!

As for rawhide treats, if you can get your pup interested in one of the Nylabone products, that would be a better choice for satisfying the chewing urge. There's tons of hard-to-digest protein and salt in the rawhides that wouldn't be the best choice. You're really lucky that your pup isn't having vomiting and inappetance issues yet. Eating is our biggest issue with this disease. Also, our vet told us it isn't a particularly painful disease, so that is a big relief.

I wish I had read this article before. I found it very informative and directional. I had to put my 13 y/o Pom to sleep this morning after a sudden and quick renal kidney failure episode. She was on so many meds that I decided to stop them. The last one was Epakitin/powder which I gave to her with a syringe. It's true what the doctor says: Somedays she will be vomiting with diarrea (diarrhea), lethargic, shaking, not eating or drinking and just sleeping. Some days she was perky, happy and playful. It was very hard for me to know when to let go. Two weeks ago, she got suddenly blind!!! I took her to the vet back and forth, but after not eating or drinking for a couple of days (in addition to the other symptoms), I took her to the vet and her BUN, creatine, and sugar values were too high to do anything about it. Euthanasia was the best and most humane option for my beloved dog. May she rest in peace.

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